Indicators of long-term survival and cure of cancer

BACKGROUNDPresently the indicators of long term survival and cure are lacking.The purpose of this work is to provide estimates of these indicators for 50 cancer types.

METHODSData from 1.6 million of Italian cancer patients diagnosed between 1976 and 2010 (AIRTUM) were included. Validated statistical models had been used to estimate four population-based original indicators of cancer cure, by sex, age and period:1. Cure fraction: proportion of patients expected to reach the same death rates of the general population;2. Time to cure: years after cancer diagnosis necessary to eliminate the excess mortality of patients vs the general population. This occurs when 5-year conditional relative survival (CRS) becomes >95%;3. Already cured patients: proportion of patients survived longer than the Time to cure; 4. Cure prevalence: the proportion of all prevalent cases who will not die of that cancer.

RESULTSThe cure fractions ranged from>90% for patients aged<45 years with thyroid and testis cancers to <10% for liver and pancreatic cancers patients. For several cancers types they increased of >10% from the 1980s to 2000s. Five-year CRS>95% is reached in <10 years by patients with cancers of the stomach, colon–rectum, pancreas, corpus and cervix uteri, and Hodgkin lymphoma. Mortality rates similar to the ones reported by the general population were reached after approximately 20 years for breast and prostate cancer patients Five-year CRS remained <95% for >25 years after cancer diagnosis in patients with liver and larynx cancers, non-Hodgkin lymphoma, myeloma, and leukemia. Time to cure was reached by 27% of all people living after a cancer diagnosis, defined as already cured. Therefore, the cure prevalence was 67% for men and 77% for women.

CONCLUSION/DISCUSSIONThe availability of these indicators has a high potential impact on health planning, clinical practice, and patients’ perspective.